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Bacteroides fragilis pelvic abscess: resolution with metronidazole therapy alone
Southern Medical Journal
|February 1, 1984
Abstract:
An 81-year-old woman had Bacteroides fragilis sepsis with a sonographically demonstrated, multiply echogenic collection in the pelvis. She failed to respond to clindamycin therapy. The patient and her family refused surgical intervention. On intravenous metronidazole alone, the patient's fever decreased, she improved, and the pelvic collection disappeared in a period of between six and 30 weeks.
Insights
Metronidazole effectively treated Bacteroides fragilis sepsis in an elderly woman with a pelvic abscess. Intravenous metronidazole alone resolved the infection and collection, avoiding surgery.
Area of Science:
- Infectious Diseases
- Medical Microbiology
- Clinical Medicine
Background:
- Bacteroides fragilis sepsis can present with intra-abdominal abscesses.
- Surgical drainage is often considered for pelvic collections.
- Antibiotic resistance and treatment failures necessitate alternative therapeutic strategies.
Observation:
- An 81-year-old female presented with Bacteroides fragilis sepsis.
- A sonographically identified, complex pelvic abscess was noted.
- The patient initially received clindamycin without clinical improvement.
Findings:
- Intravenous metronidazole monotherapy was initiated due to patient/family refusal of surgery.
- The patient experienced defervescence and clinical improvement.
- Resolution of the pelvic collection was observed over 6-30 weeks.
Implications:
- Intravenous metronidazole can be a viable alternative for treating Bacteroides fragilis pelvic abscesses.
- This case highlights the potential for successful non-surgical management in select patients.
- Further research into non-operative management of intra-abdominal abscesses is warranted.